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Trust Over Knowledge: Rethinking Donor Iron Supplementation Strategies in Modern Blood Services—Authors’ reply 信任胜于知识:对现代血液服务中供体补铁策略的重新思考——作者的答复
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-04-01 Epub Date: 2026-02-26 DOI: 10.1016/j.tmrv.2026.150962
Fleur Krommendijk , Amber Meulenbeld , Katja van den Hurk
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引用次数: 0
Trust Over Knowledge: Rethinking Donor Iron Supplementation Strategies in Modern Blood Services. 信任知识:重新思考供体铁补充策略在现代血液服务。
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.tmrv.2026.150960
RishiRaj Sinha
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引用次数: 0
Five Pathogenetic Classifications for Alloimmune Hemolytic Disease of the Fetus And Newborn 胎儿和新生儿同种免疫溶血性疾病的五种病因分类
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-12-20 DOI: 10.1016/j.tmrv.2025.150958
Hitoshi Ohto , Kenneth E. Nollet , Jill R. Storry
Maternal alloantibody-induced hemolytic disease of the fetus and newborn (HDFN) remains a significant concern worldwide. Alloimmune HDFN can be pathogenetically named by the specific alloantibodies involved. Moreover, four mechanistic pathway types are generally recognized in clinical practice: classical or extravascular hemolysis; immune-pressure-escaped, also known as antibody-mediated antigen-modulation; apoptotic or dysplastic; and failed transaction. Another proposed pathway is worthy of discussion: lactation-mediated. Management strategies for alloimmune HDFN should take account of these underlying mechanisms.
母体异体抗体诱导的胎儿和新生儿溶血病(hddn)仍然是全世界关注的一个重要问题。同种异体免疫HDFN可通过所涉及的特异性同种异体抗体在病理学上命名。此外,在临床实践中,一般认为有四种机制途径类型:经典或血管外溶血;免疫压力逃逸,也被称为抗体介导的抗原调节;凋亡或发育不良;交易失败。另一个值得讨论的途径是:哺乳介导。同种免疫HDFN的管理策略应考虑到这些潜在的机制。
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引用次数: 0
ABO matching for platelet transfusions for prevention or treatment of bleeding: A systematic review with meta-analysis 用于预防或治疗出血的血小板输注ABO匹配:一项荟萃分析的系统综述。
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-09-11 DOI: 10.1016/j.tmrv.2025.150928
Lorna Cain , Asha Aggarwal , Louise J. Geneen , Carolyn Dorée , Lise J. Estcourt , Rebecca Cardigan , Michael Desborough
Transfusion of ABO identical platelets is recommended in national guidelines, though transfusion of ABO non-identical platelets has been widely adopted to ensure availability and reduce wastage. When ABO non-identical platelets are necessitated, there is a lack of consensus on prioritisation of major or minor compatibility. We conducted a systematic review and meta-analysis (PROSPERO CRD42023450792) of randomised and non-randomised studies to assess whether there is a difference when comparing ABO-identical and non-identical (major, minor, bi-directional mismatch) platelet transfusions. From 4177 potential references, 18 studies met our criteria: 3 randomised controlled trials (RCTs), 8 prospective and 7 retrospective observational studies. Evidence was very low certainty as to whether there was a difference from transfusion of ABO identical or non-identical platelets, where data were available, for clinically significant (WHO grade 2+ and 3+) bleeding, mortality, acute transfusion reactions, platelet refractoriness. Platelet increments were the most frequently reported outcomes. Overall, there was a paucity of evidence for clinical outcome data including bleeding risk for ABO identical compared to non-identical transfusion. We make recommendations for designing and reporting future platelet ABO matching studies based on our observations in this review. Future studies should consider the effect of repeated exposure to ABO identical or non-identical transfusions and known confounders.
国家指南建议输血ABO相同的血小板,但输血ABO不相同的血小板已被广泛采用,以确保可获得性并减少浪费。当需要ABO不相同的血小板时,对主要或次要相容性的优先次序缺乏共识。我们对随机和非随机研究进行了系统回顾和荟萃分析(PROSPERO CRD42023450792),以评估abo血型相同和非abo血型相同(主要、次要、双向错配)血小板输注是否存在差异。从4177个潜在参考文献中,18个研究符合我们的标准:3个随机对照试验(rct), 8个前瞻性和7个回顾性观察性研究。在有数据的情况下,输血ABO相同或不相同的血小板在临床上显著(WHO分级2+和3+)出血、死亡率、急性输血反应、血小板难耐性方面是否存在差异,证据的确定性非常低。血小板增加是最常报道的结果。总的来说,缺乏临床结果数据的证据,包括ABO相同输血与非ABO相同输血的出血风险。基于我们在这篇综述中的观察,我们提出了设计和报告未来血小板ABO匹配研究的建议。未来的研究应考虑反复接触ABO相同或不相同输血和已知混杂因素的影响。
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引用次数: 0
Impact of Ferritin-Guided Donation Interval Policies in the Netherlands and France 荷兰和法国铁蛋白引导捐赠间隔政策的影响
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI: 10.1016/j.tmrv.2025.150959
Amber Meulenbeld , Lucile Malard , Elodie Pouchol , Mart Janssen , Syria Laperche , Jean-Baptiste Thibert , Katja van den Hurk
Many blood establishments have hemoglobin (Hb) measurement policies to prevent anemia in blood donors. However, despite evidence of iron deficiency (ID) in donors with normal Hb levels, only few blood establishments have implemented iron management strategies. Recently, the Dutch and French national blood services implemented ferritin-guided donation interval policies, albeit in different ways. While in the Netherlands ferritin is measured every 5 donations, in France ferritin measurements are performed in predefined risk groups. We compared rates of ID (ferritin <15 ng/mL), low ferritin (15-30 ng/mL), and low Hb between the Netherlands and France before and after policy implementation. We also compared donor return rates and ferritin levels after ferritin-based deferrals. We found that before the policy change there were differences in rates of ID and low ferritin, but Hb deferral rates were very similar. After the policy change, more ferritin measurements were performed in the Netherlands, but both countries had similar ID rates (∼4.5% and ∼1% of measured females and males, respectively). Return rates within one year after the end of deferral for ID were similar in both countries (∼60% for females and ∼80% for males), but French donors had higher ferritin upon return despite the shorter deferral period. Because this is an observational study using retrospective data, and due to a lack of the standardization of ferritin measurements, comparisons need to be interpreted with caution. Nonetheless, the results offer valuable insights concerning the impact of ferritin-guided donation intervals for blood establishments that consider the implementation of similar policies.
许多血液机构都有血红蛋白(Hb)测量政策,以防止献血者贫血。然而,尽管有证据表明血红蛋白水平正常的献血者缺铁(ID),但只有少数血液机构实施了铁管理策略。最近,荷兰和法国的国家血液服务机构实施了以铁蛋白为导向的献血间隔政策,尽管方式不同。在荷兰,每5次捐献检测一次铁蛋白,而在法国,铁蛋白检测是在预先确定的危险群体中进行的。我们比较了政策实施前后荷兰和法国之间的ID(铁蛋白≤15 ng/mL)、低铁蛋白(15-30 ng/mL)和低Hb的比率。我们还比较了基于铁蛋白延迟的供体返回率和铁蛋白水平。我们发现,在政策改变之前,ID和低铁蛋白的比率存在差异,但Hb延迟率非常相似。政策改变后,在荷兰进行了更多的铁蛋白测量,但两国的ID率相似(分别为测量的女性和男性的4.5%和1%)。两国在ID延期结束后一年内的回复率相似(女性为60%,男性为80%),但法国献血者在返回时的铁蛋白含量较高,尽管延期时间较短。由于这是一项使用回顾性数据的观察性研究,并且由于缺乏铁蛋白测量的标准化,因此需要谨慎解释比较。尽管如此,研究结果为考虑实施类似政策的血液机构提供了有关铁蛋白引导的献血间隔影响的宝贵见解。
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引用次数: 0
Donation-Induced Protein and Iron Depletion in High-Frequency Plasma Donors 高频血浆供者的供体诱导蛋白和铁消耗
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-12-10 DOI: 10.1016/j.tmrv.2025.150951
Femmeke Prinsze , Hans Vrielink , Yared Paalvast , Ryanne Lieshout-Krikke , Katja van den Hurk
Demands for plasma continue to rise, but the effects of frequent donations on donor-health remain unclear. The aim of this observational study was to assess associations of plasma donation frequencies with biomarker (protein, ferritin, and hemoglobin) levels, and to evaluate the contribution of high or very high-frequency donors to the collected plasma. We included all plasma donors (N = 42,390) of 2019 who donated only plasma in 2 preceding years. Total protein and hemoglobin were measured in all donors, ferritin only in a subpopulation (N = 953). Associations between the number of donations and biomarker levels were analyzed using linear regression, adjusted for age and days since previous donation, and stratified by sex and menopausal status. We grouped the donors based on their yearly donation frequency: low frequency (LF) 1 to 6, medium frequency (MF) 7 to 12, high frequency (HF) 13 to 18 and Very High Frequency (VHF) >18. Linear regression analyses showed significant negative associations between numbers of donations and protein (odds ratios: males −0.04 (−0.05 to −0.03), premenopausal females −0.09 (−0.11 to −0.03), postmenopausal females −0.05 (−0.07 to −0.04)) and ferritin levels (odds ratios: males −1.98 (−2.47 to −1.48), premenopausal females −1.81 (2.23 to −0.75), postmenopausal females −1.24 (−2.10 to −0.38)). HF- and VHF-donors (6% of donors) are predominantly male with high donation volumes, contributing approximately 17% to the amount of collected plasma. High-frequency plasma donations are associated with significantly lower protein and ferritin, but not Hb levels. Despite the low number of HF- and VHF-donors, their contribution to the plasma supply is high.
对血浆的需求持续上升,但频繁献血对献血者健康的影响尚不清楚。本观察性研究的目的是评估血浆捐献频率与生物标志物(蛋白质、铁蛋白和血红蛋白)水平的关系,并评估高频或高频供体对收集血浆的贡献。我们纳入了2019年所有在前2年仅捐献血浆的血浆献血者(N = 42390)。在所有供者中测量总蛋白和血红蛋白,仅在一个亚群中测量铁蛋白(N = 953)。使用线性回归分析捐赠数量与生物标志物水平之间的关系,调整年龄和自上次捐赠以来的天数,并按性别和绝经状态分层。我们根据捐赠者每年的捐赠频率对其进行分组:低频(LF) 1至6次,中频(MF) 7至12次,高频(HF) 13至18次,甚高频(VHF) 18次。线性回归分析显示,捐献数量与蛋白质(比值比:男性为- 0.04(- 0.05至- 0.03),绝经前女性为- 0.09(- 0.11至- 0.03),绝经后女性为- 0.05(- 0.07至- 0.04))和铁蛋白水平(比值比:男性为- 1.98(- 2.47至- 1.48),绝经前女性为- 1.81(2.23至- 0.75),绝经后女性为- 1.24(- 2.10至- 0.38))之间存在显著负相关。HF和甚高频献血者(占献血者的6%)主要是男性,其献血量很大,约占所收集血浆量的17%。高频血浆捐献与蛋白和铁蛋白显著降低相关,但与Hb水平无关。尽管HF和vhf供体数量较少,但它们对血浆供应的贡献很大。
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引用次数: 0
Reply to “Strengthening Translational Pathways: The Need for Readiness and Fairness Assessment in Transfusion AI Models” 回复“加强转化途径:输血人工智能模型的准备性和公平性评估的必要性”
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-12-13 DOI: 10.1016/j.tmrv.2025.150954
Na Li
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引用次数: 0
Analytical Review: Neutrophil Extracellular Traps and Antiphospholipid syndrome 分析综述:中性粒细胞胞外陷阱和抗磷脂综合征。
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-07-17 DOI: 10.1016/j.tmrv.2025.150909
Ayesha Butt , Anish Sharda , Alfred Ian Lee , Jason S Knight
Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder defined by the presence of one or more antiphospholipid antibodies (aPL) in conjunction with clinical manifestations such as thrombosis and/or obstetrical complications. One of the notable recent developments in APS research is the identification of a contributory role for neutrophil extracellular traps (NETs) in its pathogenesis, establishing a mechanistic link between thrombosis, inflammation, and complement activation. NETs, composed of decondensed chromatin and neutrophil-derived granule proteins, are released in response to various infectious and sterile triggers. In individuals with APS, elevated NET levels and the presence of anti-NET antibodies have been observed, aligning with thrombotic events and enhanced complement system activation. Studies support an emerging model that neutrophils are primed in APS to form NETs as a central mechanism in the development of thrombosis. This review explores multiple mechanisms linking NETs and thrombosis in APS including: contribution of aPL to enhanced leukocyte adhesion and the induction of NETosis via P-selectin glycoprotein ligand-1 (PSGL-1) and the transcription factor KLF2; cyclic AMP and the adenosine A2A receptor on the neutrophil surface as negative regulators of NETosis and thrombus formation in APS; and NET-mediated resistance to activated protein C leading to hypercoagulability, amongst others. Intervening in NET-related pathways represents a promising therapeutic strategy to mitigate thrombotic risk in APS, underscoring the need for ongoing investigation into neutrophil-mediated mechanisms in this autoimmune disorder.
抗磷脂综合征(APS)是一种自身免疫性血栓形成前疾病,由一种或多种抗磷脂抗体(aPL)的存在以及血栓形成和/或产科并发症等临床表现来定义。最近APS研究的一个显著进展是确定了中性粒细胞胞外陷阱(NETs)在其发病机制中的作用,建立了血栓形成、炎症和补体激活之间的机制联系。NETs由去致密的染色质和中性粒细胞衍生的颗粒蛋白组成,在各种感染和无菌触发条件下释放。在APS患者中,已观察到NET水平升高和抗NET抗体的存在,与血栓形成事件和补体系统激活增强一致。研究支持一种新兴的模型,即中性粒细胞在APS中被启动形成NETs,这是血栓形成的核心机制。本综述探讨了APS中NETs与血栓形成的多种机制,包括:aPL通过p -选择素糖蛋白配体-1 (PSGL-1)和转录因子KLF2促进白细胞粘附增强和NETosis;环AMP和中性粒细胞表面腺苷A2A受体作为APS患者NETosis和血栓形成的负调节因子以及net介导的对活化蛋白C的抗性,导致高凝性等。干预net相关通路是一种很有前景的治疗策略,可以降低APS患者的血栓形成风险,因此需要对这种自身免疫性疾病中中性粒细胞介导的机制进行持续研究。
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引用次数: 0
Transfusion Medicine Reviews in 2026 2026年输血医学评论
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-12-15 DOI: 10.1016/j.tmrv.2025.150956
Sunny Dzik , Jeannie Callum , Zoe McQuilten
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引用次数: 0
Vein-To-Vein Databases: Uses and Considerations in Transfusion Research 静脉对静脉数据库:在输血研究中的应用和考虑
IF 2.5 2区 医学 Q2 HEMATOLOGY Pub Date : 2026-01-01 Epub Date: 2025-11-25 DOI: 10.1016/j.tmrv.2025.150936
Antoine Lewin , Samuel Rochette , Andrew W. Shih , Alan Tinmouth , Michaël Chassé , Sheila F O'Brien , Michael P. Busch , Nareg H. Roubinian , Christian Erikstrup , Mélanie Dieudé , François Martin Carrier , Jeannie Callum , Donald M. Arnold , Canadian Transfusion Trials Group
The increasing availability of digital health data heralds a new era in transfusion research. These data can be assembled into large databases integrating donor, component, and recipient information, enabling studies across the transfusion continuum (“vein-to-vein”). However, establishing and maintaining such databases requires significant resources, and few investigators currently have access to them. To guide future efforts, we reviewed published vein-to-vein databases, focusing on their research use, data scope, limitations, and technical design considerations. Several studies have used vein-to-vein databases to examine determinants of transfusion effectiveness and safety. These studies would benefit from more international collaboration to explore variation and validate findings. Such collaborations could be facilitated through public protocol and data sharing, adherence to recognized standards, or the development of new, widely accepted ones. Investigators who develop vein-to-vein databases must consider the need for data quality and validation checks. Where feasible, investigators should also consider linking vein-to-vein data with prospective cohort studies that include donation and recipient biospecimens to evaluate novel or emerging exposures and explore epidemiological and mechanistic associations. They should also recognize the limitations of vein-to-vein database studies, including residual confounding, data quality issues, and missing data due to outpatient transfusions, home transfusions, or patients without health insurance. Despite these limitations, vein-to-vein databases should be developed, enhanced, and leveraged to provide insights into transfusion efficacy and support pragmatic or emulated randomized controlled trials (RCTs), especially where traditional RCTs are not feasible (eg, platelet thresholds to prevent bleeding complications after lumbar puncture).
越来越多的数字健康数据预示着输血研究的新时代。这些数据可以整合到大型数据库中,整合供体、成分和受体信息,从而实现跨输血连续体(“静脉到静脉”)的研究。然而,建立和维护这样的数据库需要大量的资源,目前很少有调查人员能够访问它们。为了指导未来的工作,我们回顾了已发表的静脉对静脉数据库,重点关注它们的研究用途、数据范围、局限性和技术设计考虑。一些研究使用静脉对静脉数据库来检查输血有效性和安全性的决定因素。这些研究将受益于更多的国际合作,以探索变异并验证发现。可以通过公共协议和数据共享、遵守公认的标准或开发新的、被广泛接受的标准来促进这种合作。开发静脉对静脉数据库的研究人员必须考虑数据质量和验证检查的需要。在可行的情况下,研究人员还应考虑将静脉对静脉数据与前瞻性队列研究(包括捐赠和受体生物标本)联系起来,以评估新的或新出现的暴露,并探索流行病学和机制关联。他们还应该认识到静脉对静脉数据库研究的局限性,包括残留混淆、数据质量问题以及由于门诊输血、家庭输血或没有医疗保险的患者而丢失的数据。尽管存在这些局限性,静脉到静脉数据库应该得到开发、加强和利用,以提供对输血疗效的见解,并支持实用的或模拟的随机对照试验(rct),特别是在传统随机对照试验不可行的情况下(例如,血小板阈值预防腰椎穿刺后出血并发症)。
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引用次数: 0
期刊
Transfusion Medicine Reviews
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